Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Mar 2009
Comparative StudyComparison of graft patency for off-pump and conventional coronary arterial bypass grafting using 64-slice multidetector spiral computed tomography angiography.
Off-pump coronary artery bypass graft surgery (OPCAB) has been performed for many years and its use is increasing frequently, but it remains an open question whether OPCAB provides similar patency to conventional coronary artery bypass graft (CCABG) surgery with cardiopulmonary bypass. The present study assessed the graft patency in patients that had coronary arterial bypass grafting (CABG) performed on-pump and off-pump. ⋯ Patency of left internal mammary artery (LIMA) was higher than that of saphenous vein (SVG) in both groups; no significant difference was seen in LIMA patency and SVG patency in both groups. Results of 64-slice MSCTA indicate that OPCAB provides similar patency to CCABG surgery with CPB.
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Interact Cardiovasc Thorac Surg · Mar 2009
Comparative StudyScreening methods for delirium: early diagnosis by means of objective quantification of motor activity patterns using wrist-actigraphy.
Delirium after cardiac surgery is a risk factor for adverse outcome and even death. Disturbance of motor activity is a core feature of delirium, but hypoactive delirium often remains unrecognized. We explored wrist-actigraphy as a tool to objectively quantify postoperative recovery of 24-h rest-activity patterns to improve the early recognition of delirium after surgery. ⋯ The delirious patients showed lower mean activity levels during the first postoperative night (P<0.05), reduced restlessness during the first day (P<0.05), and a lower mean activity of the 5 h with lowest activity within the first 24 h (P=0.01), as compared to the non-delirious patients. Already at a very early stage after cardiac surgery, a difference in motor activity was observed between patients with and without a delirium. As an unobtrusive method, actigraphy has the potential to be a screening method that may lead to early diagnosis and treatment of delirium.
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Interact Cardiovasc Thorac Surg · Mar 2009
Case ReportsRetrograde cerebral perfusion and delayed hyperbaric oxygen for massive air embolism during cardiac surgery.
We report a case of massive air embolism from a ventricular vent line during cardiac surgery successfully treated with emergent retrograde cerebral perfusion and delayed hyperbaric oxygen therapy. The etiologies of this rare but potentially devastating complication are discussed along with prevention and treatment options.